Food diversity versus breastfeeding choice in determining anthropometric status in rural Kenyan toddlers.

BACKGROUND Prolonged breastfeeding in developing countries is routinely recommended as a valuable and cost-effective public health measure to promote early childhood growth. However, the effects of breastfeeding beyond 12 months are unclear, with some studies showing positive, and some showing negative effects. The role of complementary foods for children 1-3 years has been less studied. METHODS We examined feeding behaviour and illness data in relation to anthropometric status among 154 rural western Kenyan children, aged 12-36 months. RESULTS There was little difference in anthropometric status between partially breastfed and fully weaned children. Rather, dietary diversity (number of different foods consumed) was strongly and consistently related to anthropometric status in this age group. In addition, early complementation with starchy gruels was associated with stunting. CONCLUSIONS Public health efforts which focus only on prolonged breastfeeding (>12 months) in developing countries will not ensure adequate early childhood growth. Important complementary feeding recommendations that promote diet diversity, through the inclusion of a variety of foods in the diets of children in the 1-3 year age group, are needed.